Pandemic Deaths Likely Much Higher Than Previously Thought

According to official records, over 1.1 million Americans have lost their lives to COVID-19. The high rates of excess deaths, however, guarantee that the actual number is much higher. 

Researchers think that undercounting occurs due to factors such as low levels of testing, lack of knowledge of COVID-19, and overburdened health systems, but a new study suggests that the actual number of deaths in the US is at least 16% higher. The study also found nearly as many uncounted excess deaths in the second year of the pandemic as in the first. Demographers sought to ascertain the potential number attributable to COVID-19 and dug into data collected at the county level to unearth temporal and geographical trends.

From March 2020 to August 2022, an additional 1.2 million people died due to natural causes; of this number, approximately 163,000 were not directly linked to COVID-19, although the majority of these deaths should have been, according to the researchers. 

More questions surfaced after they calculated the unexpectedly high number of casualties. Examining the times and places of excessive mortality helped them get closer to that solution. The researchers hypothesized that the deaths would occur during or after large surges when healthcare systems would be most overwhelmed, and healthcare workers would be sick or exhausted. On the contrary, excess fatalities started to creep up a month before the big surges. As a result of low testing rates and general ignorance about the disease, some patients may have been unaware that they were infected with COVID-19. 

Another factor that makes determining the cause of death more challenging is the increase in deaths that occur outside of hospitals, such as in private residences and nursing homes.

Since underreporting of COVID-19 fatalities did reflect public health system failures, researchers expected to see it during the first few months of the pandemic. Notable regional variation was observed in the locations of the fatalities; the non-metropolitan counties, particularly those in the south and west, were the most severely impacted. These regions lack the resources necessary to investigate deaths thoroughly and have also had lower levels of COVID testing.

To better respond to infectious diseases and be prepared for the next pandemic, the researchers stressed the importance of knowing the actual death toll from COVID-19 and explaining why it was under-counted.